Communication: Yes, is the short answer given in this meta-analysis of 17 studies evaluating interventions to “improve the communication of bad or difficult news”. Most interventions were fairly brief stand-alone interventions involving simulation or role-play; the SPIKES model was the most commonly used framework for instruction. The two most commonly assessed outcomes were observer-rated skill during a simulation exercise and physician self-rated confidence. Both of these measures showed robust short-term improvement following training. The authors mention the desirability of looking at longer-term outcomes and patient-centered outcomes. This reviewer would advise some caution on measuring the latter. Prior work has shown that patients with Stage 4 incurable cancers who did not understand they were terminally ill rated their oncologists’ communication skills better than patients who accurately understood their situation. — Laura Willett, MD